OKOJ, Volume 1, No. 7

Tendinopathy of the flexor carpi radialis classically affects both men and women in their fifties. There is a higher incidence in women. While tendon entrapment of the flexor carpi radialis (FCR) is sometimes considered an overuse syndrome, in many cases it is idiopathic, without a previous history of direct injury or repetitive wrist flexion and extension. Nonsurgical and surgical management options are reviewed, including the FCR decrompression technique.

Lumbar disk abnormalities increase with age. No one knows the actual incidence of lumbar disk herniations, as many people with herniations are asymptomatic. Ninty percent of lumbar herniations occur at L4-L5 and L5-S1. Lumbar herniations may occur with little or no trauma, although patients frequently report a bending or twisting motion as the inciting event, causing the onset of symptoms. Common causes of lumbar herniations include falls, car accidents, repetitive heavy lifting, and sports injuries of all types.

This article reviews the pathophysiology and clinical presentation of lumbar disk herniation, and reviews the nonsurgical and surgical management options for this disorder. The surgical technique of lumbar microdiskectomy is reviewed in detail. Video is available.

Lumbar spinal stenosis is a common disease process that manifests and evolves with age progression. It is one of the most frequently diagnosed conditions in adult spine patients and the most common for surgical intervention in the elderly. In essence, lumbar spinal stenosis is narrowing of the spinal canal, lateral recess, or the foramen that leads to neural compression, producing radiculopathy or neurogenic deficit. The term"stenosis"itself is derived from the Greek word stenos, which means narrow. Symptoms do vary between individuals and location of pathology. Thorough clinical evaluation must be performed and correlated to imaging studies. Conservative management is usually recommended as the first line of treatment. The extent to which a patient's activities of daily living and lifestyle are affected is particularly important in deciding on surgical treatment. Laminectomy with or without concomitant fusion can significantly improve the quality of life in carefully selected patients who have failed conservative treatment.

This OKO topic covers three surgical techniques in depth: laminectomy, spinal fusion and instrumentation, and laminoplasty. Video is available.

Keywords:

spinal canal narrowing

congenital spinal stenosis

acquired spinal stenosis

foraminal stenosis

anatomy of lumbar vertebrae

cauda equina compression

diagnosis

clinical presentation

myelography

electromyography

EMG

laminectomy

spinal fusion with instrumentation

laminoplasty

Subspecialty:

Spine

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